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WMAS says the contract is working out very differently to what was agreed and is ‘not a sustainable position without additional funding’.

Trade union GMB, which represents ambulance workers, fears patients and jobs are being put at risk.

Mike Buoey, GMB organiser, said: “West Midlands Ambulance Service made no attempt to consult with GMB before dropping this bombshell on our members who provide this vital service.

“WMAS say they will ditch the contract in 2019 and our concern now is for our members’ jobs and the vulnerable patients they transport.

“If a funding crisis is affecting the delivery of patient transport services in Cheshire, Warrington and Wirral, then both WMAS and the commissioners will need to explain why they have allowed this to happen and put jobs and patient services at risk.”

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WMAS, who will continue to deliver transport services to patients until the contract is retendered, accused GMB of ‘scaremongering’.

Michelle Brotherton, WMAS non-emergency services operational delivery director, said in a statement: “Due to the centralisation of some services, which has resulted in longer journeys, the contract is considerably different to that which was tendered in 2016.

“WMAS independently increased staffing numbers by 22 whole time equivalents over and above what was initially commissioned to protect patient care. Additional ambulances were also brought in by the trust to ensure patients received the highest standards of care.

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“Unfortunately, this is not a sustainable position without additional funding. As a trust we were not prepared to provide a sub-optimal service based on the funding – that would not have been fair to staff or patients.

“WMAS has been working with commissioners for over six months to find a way forward. We completely understand the reasons why the CCGs (clinical commissioning groups) were unable to increase the funding, which has triggered the need for us to withdraw.

"We are confident that whoever wins the new contract will see additional funding and investment which will protect jobs and ensure patient care remains the highest priority.”